02/07/2024

In the journey towards overcoming substance use disorders, individuals often face numerous challenges. One crucial element that has emerged as a beacon of hope is recovery housing. This blog post aims to shed light on the impact of recovery housing on individuals in substance use recovery, highlighting the benefits it offers not only to those seeking recovery but also to the communities they are a part of.

Understanding Recovery Housing:
Recovery housing refers to supportive and drug-free environments designed to help individuals in substance use recovery maintain their sobriety and transition successfully into mainstream society. These residences provide a structured and safe space where individuals can focus on rebuilding their lives, free from the triggers and temptations that might hinder their recovery.

Impact on Individuals:

Structured Support: Recovery housing offers a structured environment with clear guidelines and rules, providing individuals with the support they need to stay on track with their recovery journey.

Peer Support: Living with others who are on a similar path creates a strong sense of community and understanding. Peer support plays a pivotal role in recovery, fostering a sense of belonging and reducing feelings of isolation.

Rebuilding Lives: Individuals in recovery often need to rebuild various aspects of their lives, including employment, education, and relationships. Recovery housing facilitates this process by offering a stable foundation for personal and professional growth.

Benefits to the Community:

Reduced Relapse Rates: By providing a supportive environment, recovery housing contributes to lower relapse rates among individuals in recovery. This not only benefits the individuals themselves but also reduces the strain on community resources related to addiction treatment.

Enhanced Public Safety: Individuals in recovery housing are less likely to engage in criminal activities associated with substance use. This enhances public safety and contributes to the overall well-being of the community.

Economic Productivity: As residents of recovery housing rebuild their lives, they become valuable contributors to the workforce and society. This, in turn, positively impacts the economic productivity of the community.

Conclusion:
Recovery housing is a vital component in the holistic approach to addressing substance use disorders. It not only empowers individuals in their recovery journey but also brings about positive changes in the communities they are a part of. By providing a supportive and structured environment, recovery housing becomes a catalyst for transformation, fostering hope, healing, and lasting recovery.

12/29/2023

As we get ready for the new year, it’s time to think about the past and what’s ahead. At Perception Programs, we want to say a big thank you for everything that happened in 2023. We’ve had lots of experiences, met new people, and got the chance to help more folks who needed support for their mental health.

Thinking about the year, what really stands out is all the amazing people we’ve been able to help. Each person we’ve talked to and supported has made our work feel important. Your trust in us keeps us going and helps us keep doing what we do – helping people who need support with their mental health.

This year has been a time when we’ve learned a lot and grown as a team at Perception Programs. The things we’ve experienced and the stories we’ve heard have made us better at what we do – supporting mental health and helping more people.

Why Thinking About the Year Helps

Looking back at what’s happened helps us see what we’ve achieved and where we can do better. It’s like taking a picture of where we are on a map – it helps us see where we want to go next.

Making Plans for the Future

Writing down what we’ve achieved and what we want to do next helps us understand what we want for the future. It’s like making a plan for a trip – it helps us know where we want to go and how we’re going to get there.

To help you think about your own year, we’ve made a simple New Year Reflection Worksheet. This worksheet helps you think about the good things from the past year, what you’re proud of, what you’ve learned, and what you want to do next year. You can use it to help you think about your own plans for the new year.

New Year Reflection Worksheet:

Good Times: Write down some of the best things that happened to you in 2023.
Stuff You Did Well: Think about things you did that you’re really proud of this year.
Problems & Learning: What were some hard things you faced, and what did they teach you?
Thank You Moments: Say thanks for people, things, or experiences that made you happy this year.
Plans for 2024: Write down things you want to do or achieve in the new year.
As we say goodbye to 2023, let’s remember the good stuff, say thanks, and think about what we want for the next year. Let’s keep working together for better mental health, using what we’ve learned, and being grateful for the good things.

Here’s to a new year full of good things!

12/08/2023

In the digital age, social media has become an integral part of our lives, influencing how we connect, share, and consume information. While excessive use can sometimes have negative impacts on mental health, when used mindfully, social media can be a tool for enhancing well-being. Here are several ways to leverage social platforms to improve mental health:

1. Cultivate a Positive Feed:

Reference: A study published in the Journal of Experimental Psychology suggests that exposure to positive content on social media can improve mood and well-being.

Actionable Tip: Follow accounts that inspire, motivate, and spread positivity. Curate your feed to include uplifting content, such as motivational quotes, success stories, or posts from accounts focusing on mental health and self-care.

2. Foster Supportive Communities:

Reference: Research from the Journal of Medical Internet Research shows that engaging in online communities can provide social support, reducing feelings of loneliness.

Actionable Tip: Join groups or communities that align with your interests or challenges. Engage in discussions, share experiences, and offer support to others. These connections can provide a sense of belonging and understanding.

3. Practice Mindful Consumption:

Reference: Studies published in Cyberpsychology, Behavior, and Social Networking suggest that mindful social media use can lead to decreased feelings of anxiety and depression.

Actionable Tip: Be conscious of your social media habits. Set boundaries for usage, take breaks when needed, and unfollow or mute accounts that negatively impact your mental health. Practice being present and engaged in the moment.

4. Utilize Mental Health Resources:

Reference: According to the American Psychological Association, many social media platforms offer mental health resources and support.

Actionable Tip: Explore mental health resources available on social media platforms. Many provide access to helplines, support groups, mindfulness exercises, and expert advice. Seek credible sources for guidance and support.

5. Engage in Positive Self-Expression:

Reference: Studies in Health Communication show that self-expression on social media can have positive effects on self-esteem and mental health.

Actionable Tip: Use social media as a platform for positive self-expression. Share your accomplishments, creative endeavors, and moments of gratitude. Expressing yourself authentically can boost self-worth.

Conclusion:

When utilized consciously and intentionally, social media can be a valuable tool for improving mental well-being. By curating a positive feed, fostering supportive connections, practicing mindfulness, accessing mental health resources, and engaging in positive self-expression, individuals can leverage social platforms to enhance their mental health.

Remember, balance and moderation are key. Understanding your limits and the impact of social media on your mental health is essential for harnessing its benefits while mitigating potential downsides. Use social media as a tool to empower yourself and others in your journey towards better mental well-being.

10/24/2023

Seasonal Affective Disorder (SAD): A Deep Dive into the Winter Blues 

Seasonal Affective Disorder, commonly known as SAD, is more than just a fleeting feeling of sadness during the colder months. It’s a recognized mood disorder that can profoundly affect one’s well-being. In this blog post, we’ll explore the intricacies of SAD, its targeted demographics, symptoms, and potential treatments, drawing insights from recent scientific literature. 

What is Seasonal Affective Disorder? 

SAD is a subtype of major depressive disorder or bipolar disorder. It’s characterized by depressive symptoms that emerge during specific seasons, typically in the fall or winter, and remit during other times, such as spring or summer (Galima, Vogel, & Kowalski, 2020). The reduced level of sunlight during the colder months is believed to disrupt the body’s internal clock, leading to mood disturbances. 

Who is Most Susceptible? 

Certain groups appear to be more vulnerable to SAD: 

1. Women are more likely to be diagnosed than men (Galima et al., 2020). 

2. Young Adults risk is higher during young adulthood (18 to 30) and tends to decrease with age (Galima et al., 2020). 

3. Geographical Location: Living farther from the equator, where winter daylight is notably short, increases susceptibility (Galima et al., 2020). 

Recognizing the Symptoms 

The symptoms of SAD mirror those of regular depression but recur seasonally: 

– Persistent feelings of sadness or irritability 

– Loss of interest in previously enjoyed activities 

– Fatigue and a strong desire to sleep 

– Cravings for carbohydrates and potential weight gain 

– Feelings of hopelessness, guilt, and worthlessness (Galima et al., 2020) 

Navigating Treatment Options 

There are several evidence-backed treatments for SAD: 

1. Light Therapy: Exposure to a unique lamp miming natural sunlight is a primary treatment for winter SAD (Galima et al., 2020). 

2. Antidepressants: Second-generation antidepressants (SGAs) have shown promise in treating SAD (Nussbaumer-Streit et al., 2021). 

3. Cognitive-Behavioral Therapy (CBT): CBT addresses harmful thought patterns and offers coping strategies, proving beneficial for SAD (Camuso & Rohan, 2020). 

4. Lifestyle Interventions: Increasing exercise and exposure to natural light can also be beneficial (Galima et al., 2020). 

Supporting Those with SAD 

Understanding and empathy are crucial for those grappling with SAD. Please encourage them to seek professional help and explore the aforementioned treatments. Lifestyle changes, such as maintaining a regular sleep schedule, engaging in outdoor activities, and seeking social support, can also make a difference. 

Perception Programs: Your Partner in Mental Health 

Perception Programs is dedicated to assisting those battling SAD. With a team of seasoned professionals, they offer tailored therapeutic strategies to address the unique challenges posed by this disorder. If you or a loved one is struggling with SAD, don’t hesitate to contact Perception Programs at (860) 450-0151. Our expertise can guide you toward better mental well-being. 

References 

Camuso, J., & Rohan, K. (2020). Cognitive Vulnerabilities in Seasonal Affective Disorder Treatment. Cognitive Behavior Therapy, 93-107. 

Galima, S. V., Vogel, S. R., & Kowalski, A. W. (2020). Seasonal Affective Disorder: Common Questions and Answers. American Family Physician, 665-670. 

Nussbaumer-Streit, B., Thaler, K., Chapman, A., Probst, T., Winkler, D., Sönnichsen, A., & Gartlehner, G. (2021). Second-generation antidepressants for treatment of seasonal affective disorder. Cochrane Database of Systematic Reviews. 

10/04/2023

While the dialogue about mental health has progressively evolved, the persistent stigma associated with behavioral and mental health disorders continues to pose a substantial obstacle, particularly within low-income communities in the United States. The challenges encountered by these communities are multifaceted, weaving socio-economic factors and mental health into a complex tapestry.

The Persistent Stigma of Mental Health

 

The stigma related to mental health issues frequently serves as a hindrance for individuals in pursuit of help. This stigma manifests externally and internally, as individuals might internalize societal norms and prejudices, intensifying feelings of shame and inadequacy (Alegría, Nakash, & Nemoyer, 2018). The apprehension of being categorized or ostracized due to mental health challenges is especially pronounced in close-knit communities, where information travels swiftly, and reputations are difficult to mend.

Obstacles in Low-Income Communities

 

Distinct challenges arise for low-income communities regarding access to mental health resources. Economic barriers, such as the financial strain of affording therapy or medication, and obstacles like lack of transportation or inflexible work schedules, impede access to vital mental health services. Furthermore, these communities often lack sufficient information about where and how to secure care, expanding the mental health treatment gap (Alegría et al., 2018).

The Consequences of Scarce Resources

 

Scarce resources in low-income areas imply that even when individuals surmount the stigma and seek help, the necessary support may be unattainable. The scarcity of mental health professionals, lack of funding, and inadequate infrastructure in these communities establish a notable barrier to accessing mental health care. Additionally, the available resources might not be culturally adept or adapted to the community’s specific needs, which is vital for effective mental health care.

Advocating for Equitable Access and Quality Care

 

Addressing these challenges demands a holistic approach that not only aims at diminishing stigma but also assures equitable access to quality mental health care. Strategies like community-based interventions, peer support programs, and digital training for local health workers have demonstrated potential in various contexts. These strategies allow the needs of low-income communities in the United States to be addressed (Gandhi, Sequeira, Garg, & Nadkarni, 2023).

Conclusion

Dismantling the barriers to mental health care in low-income communities in the United States requires the deconstruction of the stigma surrounding mental health and addressing the systemic issues that obstruct access to care. By cultivating an environment that promotes transparent dialogue about mental health and ensuring that resources are accessible and suitable, we can significantly stride towards supporting the mental well-being of all individuals, irrespective of their socio-economic status.

References

Alegría, M., Nakash, O., & Nemoyer, A. (2018). Increasing equity in access to mental health care: a critical first step in improving service quality. World Psychiatry, 17(1), 43–44. DOI: 10.1002/wps.20486

Gandhi, Y., Sequeira, M., Garg, A., & Nadkarni, A. (2023). Development of a digital training and community-based intervention to increase help-seeking for depression and adherence to treatment in Goa, India. DOI: 10.21428/3d48c34a.c431680c

By Charles Bittner

02/28/2023

This post is a bit different than my previous posts, but important, nonetheless. Whether you are a person who uses/used drugs, know someone that uses/used drugs, or if you work with folks who use, this community alert post is for you!

The Issue

A (somewhat) novel substance called Xylazine is showing up in the illicit drug supply [especially in the Northeast]. Xylazine is most commonly found in illicit opioid substances, such as fentanyl, pressed pills, and heroin, but is also increasingly being found in other substances such as cocaine or meth.

According to Christine Vestal, a staff writer for Stateline, “Xylazine started showing up routinely in the drug supply in 2019 but didn’t take off until the coronavirus pandemic began in 2020 (Vestal, 2023). The Northeast is most significantly impacted by this novel substance, with CT ranking 3^rd highest out of all these United States, regarding

What We Know

According to the Food and Drug Administration, Xylazine (Zie-luh-zeen) is a non-opioid agent that FDA originally approved in 1972 as a sedative for use in veterinary medicine and is not approved in the use of humans (FDA, 2022).” Xylazine may be sold under the common street names, tranq, tranq dope, sleep-cut, and gas station heroin.

Associated Health Risks

– Heavy sedation

– Significant risk of overdose & death

– May impact the body’s ability to carry oxygen to tissues, causing severe skin wounds

– agitation, severe anxiety, a feeling of unease

– high blood pressure & rapid heart rate, though not always present

Repeated exposure or use may lead to dependence & withdrawal symptoms. Some users report Xylazine withdrawal symptoms as being as, or more, severe than heroin or methadone; symptoms include sharp chest pains & seizures (DEA, 2022). Xylazine withdrawal symptoms may interfere with or undermine any efforts of obtaining appropriate OUD treatment and may even further perpetuate an individual’s drug use, according to the DEA (2022).

Xylazine & Naloxone

– Xylazine does not respond to Naloxone, however, Naloxone should always be administered anytime an opioid overdose is suspected

– Oxygen therapy/rescue breathing must be administered in the event Naloxone is not effective in the reversal of the overdose event, highlighting the heightened importance of calling 911 in the event of an overdose

– More education must be provided to the public, to dispel many misconceptions on how to respond to an overdose appropriately, including how much Naloxone to administer & the need to provide rescue breathing between doses of Naloxone

How WE Can Respond

-Share the signs & symptoms of xylazine exposure with PWUD and folks that work with at-risk individuals

The most critical thing we can do is continue to educate the public about the presence of Xylazine in the drug supply, especially increasing awareness among folks most at-risk for encountering the drug. A great example is depicted below. The Savage Sister organization passes out these informational cards to people who use drugs during street outreach in Pennsylvania.

References

https://www.fda.gov/drugs/drug-safety-and-availability/fda-alerts-health-care-professionals-risks-patients-exposed-xylazine-illicit-drugs

https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2023/02/08/states-cities-scramble-to-combat-animal-tranq-in-street-drugs

Farm to City: Xylazine as a Drug of Abuse

In Philadelphia, ‘tranq’ is leaving drug users with horrific wounds. Other communities are bracing for the same

01/06/2023

Working in the human services field is hard work, but working with at-risk and underserved populations, such as those living with substance use or other mental health disorders, reaches another level of difficulty. Peer workers, like myself, experience an array of traumatizing events through our daily work, such as losing participants/clients to overdose. A recent study suggests, that “even a single exposure to a fatal or non-fatal overdose can lead to considerable stress, burnout, and overdose-related compassion fatigue (Mamdani, et al, 2021).” As peer workers, we are exposed to traumatic events such as overdose on an ongoing basis, which creates the perfect environment for compassion fatigue & burnout to occur.
As a peer worker, the following are just a few examples of what I experience through my work; a participant overdosed twice in just 6 days. Another woman I am working with lost custody of her children, she is, of course, devastated. There are several individuals living outside (in New England in January, nonetheless), and all we, (outreach/peer workers) can do is offer food, warm clothing, supplies, and of course, linkage to community resources & support(s) when/if the need is identified by the individual.
Now, consider the impact(s) on police officers, paramedics, and other frontline workers who respond to the ever-increasing opioid overdoses, witnessing people overdose, some fatal, sometimes multiple times in a single shift. Not only that but the frustration peer workers experience hitting barrier after barrier while trying to link individuals to opioid use disorder (OUD) services and very limited treatment options. Additionally, there is absolute heartbreak when we are confronted with knowing there is nowhere to send individuals coming to us seeking housing resources.
Quite frankly, for many folks, living outside [exposed to the elements] is a more appealing & safer bet than going to a shelter or asking for help because of the stigma, shame, & judgment they fear they will face, and from my experience, they are not wrong to worry about such things. If you recall in my last blog, I told a few participants’ accounts of facing judgment, shame, & discrimination while trying to access services in local emergency departments for their opioid use disorder. There are hundreds more stories such as these of individuals trying to access housing resources.

Self-Care is Key

As an empath, this all weighs on me as I am sure it weighs on all of us doing this hard [at times, impossible] work, which I have been doing for almost 10 years now and luckily got some sound advice during that time that has stuck with me throughout the years. And, of course, there were some lessons I just had to learn the hard way, through my own mistakes. Learning to care for my own well-being [FIRST]was imperative to my ability to continue doing this incredibly rewarding, but often, painful work. Peer workers must ensure they take intentional steps to ensure they care for their emotional, spiritual, physical, and mental well-being before they can effectively help anyone else.

Key Components of Compassion Fatigue (CF)

According to Ontario HIV Treatment Network (2019), there are 3 main components of experienced among service providers addressing substance use include “emotional exhaustion (feeling drained of all emotional capacity), depersonalization (experiencing cynicism, helplessness, and detachment), and lowered sense of personal accomplishment (a belief that one’s work is not significant).” Working with victims of violence and trauma changes the worldview of service providers (peer workers) and puts individuals and organizations at risk for a range of negative consequences (Bell, et al., 1990).” Organizations have a significant impact on a peer worker’s risk for experiencing CF, including “a reduction in the workforce, inadequate training & development opportunities for peer workers, and the lack of an appropriate venue to express feelings (Dougherty & Horowitz, 2021).”

Sources

The following are well-known sources of burnout among peer workers; unreasonable client caseloads, the balance of work/home/community commitments, a negative work environment (including inequitable pay compared to non-peer colleagues), and lack of colleague support/recognition (whether only perceived or reality). The Peer Recovery Center for Excellence stated, “unaddressed secondary trauma often leads to compassion fatigue, and if left unaddressed, CF may result in burnout, that according to many studies, may not be reversible (Dougherty & Horowitz, 2021).

Implications

Vicarious trauma also referred to as secondary stress trauma (SST) can have far-reaching impacts which include, higher staff turnover rates, poorer job performance, and, unfortunately, some peer workers may even return to using substances due to this work-related stress. Lack of self-care, boundaries and proper supervision are also contributing factors.

Interventions
More research needs to be done surrounding the impact CF & BO has on peer workers, however, with the implementation of policies, procedures, practices, and programs, vicarious trauma-informed organizations can be created, according to the Vicarious Trauma Institute (2015). The Peer Recovery Center for Excellence provides examples of how to reduce your likelihood of CF & BO from occurring, in their 2021 Online training titled, “The Impact of Compassion Fatigue in Peer Support Work.” The training lists “building compassion satisfaction, as well as building blocks of empathy and healthy detachment” as ways to reduce your risk of experiencing CF or BO (Dougherty & Horowitz, 2021). Compassion satisfaction & compassion fatigue can be looked at as the positive & negative consequences of doing peer support work.

My Plan to Reduce Peer Worker’s Risk of CF

I have found that I best process the trauma, grief, & loss I experience in this work by talking about it with my fellow peers. It is beyond reassuring to know that the person you are sharing your experience with can empathize with the feelings you are experiencing through their own lived experiences. Peer support work is evidence that representation and lived experience, matters! We can create as many vicarious trauma-informed policies as we want, but if peer workers do not have a seat at the [planning] table, the future success of said policies is questionable at best. That is why I have decided, with the support of PPI’s leadership team’s support to create a Peer Worker Alliance group (not settled on the name yet, lol). The group will provide a safe space for peers to connect with their peers who are doing similar work in the surrounding area to discuss, process, and support each other through the myriad of issues that arise in this work, including secondary traumatic stress, compassion fatigue, & burnout. My hope is to eventually provide training and workforce development opportunities through this group as well.
Stay tuned for more information surrounding this new endeavor! I am very excited to get started and will provide you with more information as soon as I am able. As always, if you or someone you know is living with substance use disorder and are in need of treatment services, recovery support(s), or harm reduction supplies, including Naloxone, please feel free to call/text me, Jess, @ 860-336-9412!

Key Terms
Peer Workers “Peer workers or “peers” (workers with past or present drug use experience) are at the forefront of overdose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD), according to BMC Psychiatry (2022).”
Compassion is “a feeling of deep sympathy and sorrow for another who is stricken by suffering a misfortune, accompanied by a strong desire to alleviate the pain or remove its cause, according to the Peer Recovery Center of Excellence (Dougherty & Horowitz, 2021).”
Fatigue is “extreme tiredness, typically resulting from mental or physical exertion or illness (Dougherty & Horowitz, 2021).”
Compassion fatigue (CF) is “the physical, emotional, and psychological impact of helping others, often through traumatic or stressful life events, according to WebMD (2020).”
Compassion satisfaction (CS) is defined as “the pleasure we derive from being able to do the work we do. The compassion we experience in doing our work provides a sense of satisfaction (Dougherty & Horowitz, 2021).”
Burnout (BO) is defined by the World Health Organization (WHO) as “physical and mental exhaustion caused by a depleted ability to cope with one’s everyday environment (WHO, 2019).”
Vicarious trauma (VT) is “the exposure to the trauma experiences of others” (Peer Support, 2003), and is reportedly an occupational challenge for peer workers and many other professions.
Self-care “is an essential social work survival skill and refers to activities and practices that we can engage in on a regular basis to reduce stress and maintain and enhance our short- and longer-term health and well-being. (University at Buffalo, 2023).”

References
Compassion Fatigue: Symptoms To Look For (webmd.com)
The Bell Tolls for Thee & Thine: Compassion Fatigue & the Overdose Epidemic – ScienceDirect
https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00449-1
PowerPoint Presentation (peerrecoverynow.org)
Introduction to Self-Care – University at Buffalo School of Social Work – University at Buffalo

10/31/2022

I am going to share a few experiences from the field, telling the stories of individuals I have had the pleasure of meeting in the last nine or so years that I have been involved in this work. I hope it provides a unique insight into the lives of individuals living with substance use disorder (SUD), and the impacts of living with that medical condition. My hope is that by telling these stories, shining a light on the egregious mistreatment, discrimination & for some,
downright medical neglect, will reduce the consistent barriers and overall harm(s) people living with SUD experience while on their journey of recovery/remission from SUD/OUD.
The individuals who were brave enough to allow me to share their experiences with all of you will remain anonymous to protect their confidentiality. First, I thought I’d qualify a bit by sharing one of my experiences facing judgment, shame, and discrimination within a self-help community.

My Story
I recently celebrated 10 years in remission from opioid use disorder (OUD)! For the first 7.5 years of my journey, I had been extremely active in a well-known self-help group, I shared my experience, strength, & hope as part of the H&I committee, which is a program that brings members of the self-help group to treatment programs and inside jails/prisons to share their journey of recovery & stories of hope. I actively worked with a sponsor, writing the twelve steps, sponsored women, guided them through the steps, and held just about every trusted position one can hold within the organization. The thing is, to hold most (if not all) of those positions, to sponsor those women, to bring my message of hope to other individuals inside hospitals & institutions (treatment settings), I had to lie, or at least felt the need to omit a very significant part of my story of recovery. Because of the stigma associated with the use of Suboxone to treat OUD, I did not feel safe sharing that part of my story.
Secrets Keep You Sick
Secrets eat at you, they will grow into shame and guilt, and if you are not careful, may result in a setback/relapse. Luckily, that wasn’t part of my story. But the loss of my soulmate/best friend & the father of my son gave me the strength, to be honest with the friends who felt more like family, about being on a medication used to treat OUD, and those relationships changed. All of them. Talk about the feeling of shame and abandonment. But today, I live authentically & have friends who love me unconditionally, regardless of what medications or methods I use to continue my journey of recovery. Today, I get to use my experience to encourage others to live out loud, without shame. I like to say my biggest objective in this work is to provide a safe space allowing individuals to come just as they are, feeling safe without fear of judgment.

According to an Online NIH Journal, titled “Overcoming medication stigma in peer recovery: A new paradigm”, “This stigma has particularly been expressed as an issue among NA groups. NA states in its official literature that although all individuals should be welcome to attend meetings, those who use medications are not yet considered “clean” and groups may choose to prevent individuals on medication from sharing experiences or leading meetings (NIH, 2019).”

“L’s” Story
A woman I’ve known for many years shared many of the instances of shame, stigma, and discrimination and how its impacted her recovery journey. “L” shared with me a time she went to the emergency room with a torn ligament and another type of injury of the knee. “L” reported that before she even saw a doctor, she was told by a nurse, “we cannot give you narcotics!” Here’s the thing though, she hadn’t asked for narcotics, she wouldn’t ask for them, because she is on Methadone (medication to treat opioid use disorder). We all know the stigma associated with medications used to treat OUD. “L” was discharged with nothing but a list of local specialist doctors to call. It would take several more humiliating trips to the emergency room and many appointments with primary care and specialist providers before “L” found any relief for her pain. Medical professionals if you are reading this, PLEASE, do better.

“B’s” Story
Meaningful employment is another significant and continuous barrier that people who use(d) drugs face. “B” has been in remission for nearly three years, and has had no additional involvement with the criminal justice system in that time, yet continues to run into roadblock
after roadblock while trying to find employment. For instance, “B” has completed all the relevant qualifications and certifications courses to become a Recovery Coach, but as soon as a potential employer runs a criminal background check, they are excluded from the hiring process.
Remember, this is to work within the recovery community, if they cannot get hired here, then where?

Peer Work’s Where It’s At
We know peer support works. It is a very effective method for engaging at-risk and underserved population(s), especially those living with substance use disorder. According to a Substance Abuse and Mental Health Service Administration (SAMHSA) study, titled, “Value of Peers”, peer recovery support provides the following, “improved relationship with treatment providers, increased treatment retention, increased overall satisfaction with the treatment
experience, improved access to social support greater housing stability, reduces emergency service utilization, reduced re-hospitalization rates, reduced substance use, and a decrease of criminal justice involvement (SAMHSA, 2017).”
If individuals with lived experience with substance use disorder can offer all these benefits to people currently struggling, why is their past criminal justice involvement held against them? We know people who use drugs often commit crimes to support their substance use. When individuals stop using and engage in the treatment, in most cases the criminal acts stop too. Program Directors and Human Resource Personnel must keep this fact front of mind
while seeking candidates to fill peer recovery support positions.

“D’s” Story
“D” is a participant of mine who reported he had gone to a local emergency room in opioid withdrawal, requesting to be started on Suboxone, which has been promoted in the addiction field as an option at this hospital. Not only did this individual NOT get to start treatment for his OUD, but a nurse laughed out loud and reportedly said, “We don’t do that here, I can give you a Tylenol.” He was discharged without any assistance for his medical issue, which
OUD, is, in fact, a well-documented medical disorder. This individual was not only discriminated against, but he was also humiliated, and most tragically, he was discharged with not even a list of resources. Luckily, he found his way to Perception Programs’ Mobile MAT Van and was able to start treatment for his OUD and begin his recovery journey.

Do No Harm
These stories are the rule, not the exception, when regarding how people with substance use issues, even those in remission, face mistreatment, and stigmatization, and often are either dismissed entirely or treated as if they are undeserving of resources, services, and support simply because of their medical disorder. My goal is to continue to shed light on this issue, increasing the community’s awareness of the problem, which will hopefully put pressure on institutions, organizations, and other treatment & hospital systems to ensure ALL individuals they serve receive the dignity & respect they deserve. The overarching goal, above all else… do not harm.

If you or someone you know may benefit from any of the services offered on the Mobile MAT Van, please contact Jess @ 860-336-9412. We can also be found on Facebook, Instagram, our website, or by calling any of our three offices. 

References

Krawczyk, N., Negron, T., Nieto, M., Agus, D., & Fingerhood, M. I. (2018).
Overcoming medication stigma in peer recovery: A new paradigm. Substance abuse, 39(4), 404–409. https://doi.org/10.1080/08897077.2018.1439798
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6087684/
https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/valueof-
peers-2017.pdf

09/08/2022

 

I wanted to circle back to something I have put great emphasis on in my previous posts,which is the importance of raising awareness surrounding the stigma associated with substance use and how it impacts those living with substance use disorder (SUD), more specifically, opioid use disorder (OUD). I do not like raising an issue, without also providing solutions. I will discuss why I view stigma as a human right’s issue, as evidenced by what I observe in the field. I will also provide ways in which we can all help reduce the stigma & shame people living with SUD face.

One Peer’s Perception

Through my professional & lived- experiences working, living, & recovering within the substance use community, I have attained this deeply -rooted belief that stigma is a moral & social justice issue, that is causing significant barriers to people accessing treatment services & supports for their use, increases people using alone, which dramatically increases the chance for overdose & death.

In my role as a Mobile Outreach Worker (MOW), I spend countless hours, having countless conversations, with countless individuals, debunking myths & misinformation surrounding OUD

& MOUD. It is my job to provide people with facts about opioid use disorder & the medications used to treat it. Facts that are backed by science & grounded in evidence.

Somehow I am still amazed each time I hear people say things like they don’t support MOUD treatment because they don’t view it as really being in “real recovery”, or it is “replacing one drug for another.” Neither of these are true. In fact, SAMHSA’s website states, “Medications used for MAT are evidence-based treatment options and do not just substitute one drug for another (SAMHSA).”

The Impact

The stigma people experience around their substance use can have devastating results, which may include the loss of hope for themselves & their recovery, how they are perceived, or even treated within our systems and institutions (hospitals, jails, treatment facilities, self-help groups, etc.).

SUD stigma can also have a great impact on the families of these individuals, fostering a lack of understanding & support for their loved one who is struggling, instead of creating space that feels safe enough for them to ask for help .

Stigma is so deeply ingrained in how society discusses , views, and treats those struggling with SUD. This concept proves true whether discussing people in remission/recovery from OUD, those on a MOUD as part of their treatment regimen, such as myself, or, most importantly, individuals who are in current active or chaotic use.

MAT Stigma

Individuals who are prescribed medications used to treat their opioid use disorder (MOUD), like Suboxone and Methadone, often face additional stigma and discrimination surrounding their use of these medications, it’s impact felt on multiple levels. According to an Online Medical Journal, titled “Human Rights, Stigma, and Substance Use,” “medication assisted treatment (MAT) is the current gold standard of care for treatment for opioid dependence, since its use is associated with reduced risk for relapse and mortality, yet stigma may present a barrier to its use, including stigma associated with MAT use within sectors of the treatment community, (Wogen & Restrepo, 2020).”

A Silent Killer

I will never forget a participant I lost a few years ago because of the stigma associated with/MAT. Part of a self help group, he wanted to write the 12 steps with his sponsor. His sponsor told him he would need to get off of methadone before he could start writing the steps with him. Heeding his mentor’s advice he got off the methadone and died less than 2 weeks later from an overdose. “Some peer led groups and 12 step recovery support programs may not support MAT use, and consequently individuals in recovery who are on MAT may experience stigma from peers or group facilitators or, perhaps unintentionally, be persuaded to discontinue MAT use”, according to Wogen & Restrepo, (2020).

What can be done?

In my opinion, the single best way to combat the stigma associated with SUD is utilizing Person-First Language when discussing substance use, treatment, & recovery. Words are extremely powerful and the words we use to discuss SUD or any other mental health condition, undoubtedly has an impact on society’s perceptions, attitudes and behaviors toward those living with SUD. “Language frames what the public thinks about substance use, treatment, and recovery, and it can affect how individuals think about themselves and their own ability to recover ”, according to NIH’s Online Medical Journal (Wogen & Restrepo, 2020).

We also must be willing to hold the people around us, whether our friends, family members or colleagues, accountable for the words they use to discuss SUD. Of course there will always be those who refuse to increase their knowledge or change their views, attitudes or behavior towards people with SUD, but I refuse to be one of them. I always try to remain teachable in everything I do or know.

I have included a few resources that provided examples of person-first language surrounding substance use.

References

https://www.samhsa.gov/medication-assisted-treatment

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7348456/

https://www.safeproject.us/resource/person-first-language/

If you or someone you know may benefit from any of the services offered on the Mobile MAT Van, please contact Jess @ 860-336-9412. We can also be found on Facebook, Instagram, our website, or by calling any of our three offices. 

07/22/2022

Additional Barriers to Accessing MAT Services

In my last blog post I discussed the significance that transportation barriers can play in access to care. There are many other barriers individuals face while seeking treatment for their substance use, these include, treatment capacity (long waitlists) and a lack of willing and trained providers with available time is a challenge. Additionally, the stigma associated with MAT treatment cannot be underestimated, fear of losing employment or incarceration, cost of treatment, shame & stigma associated with SUD treatment, [especially stigma associated with MAT treatment], lack of treatment resource knowledge, and the fear of losing their children (DCF involvement). 

The Need for Mobile MAT Services

The Mobile MAT van will be going to six CT communities, including Willimantic, Danielson, Putnam, Jewett City, Norwich & Taftville. Estimates show that 53% of counties in the U.S. lack access to a MAT provider (Barriers to MAT, n.d.).” Before the Mobile MAT program servicing these rural CT communities, they would have most likely been included in the 53%. The need for these services is dire. An example of how desperately OUD services are needed. I went to Jewett City last week (before the official launch of the MAT van) to pass out flyers, introduce myself and get a lay of the land.  In less than an hour and a half I had had made connections with three individuals, connected another individual to Suboxone services, distributed 6 Narcan kits, 8 fentanyl testing strips, 3 safe use kits, 40 sterile syringes, 60+ condoms, and 3 wound care kits. 

Mobile MAT Van Services & Supports

The Mobile MAT van provides a safe, non-judgmental & supportive environment for [all] individuals. Whether a person is ready to engage in Suboxone treatment for their OUD, or the individuals that may not be ready to stop their use, we have services & supports to help. The MAT van offers an array of harm reduction, prevention, and recovery support services, including community-based Suboxone induction, safe use supplies (syringes, safe use kits, Narcan), linkage to mental health & primary care services, referrals to treatment [detox, IOP, Methadone, etc.], access to peer support services, and connection to other community resources. 

I recall a time, not too long ago when individuals seeking MAT services (specifically Suboxone) would often be told to either callback in a few days or be given a first-time appointment 2 weeks out. I often wonder how many lives we lost to overdose due to those unacceptable long wait periods.  

MAT Saves Lives

Using a harm-reduction, person-centered approach, meeting individuals where they are [quite literally] to provide these critically important services, will most certainly save lives. 

If you or someone you know may benefit from any of the services offered on the Mobile MAT Van, please contact Jess @ 860-336-9412. We can also be found on Facebook, Instagram, our website, or by calling any of our three offices.